The 28-year-old woman had sought treatment at the Stockholm South General Hospital (Södersjukhuset) in May 2007 because she was having trouble getting pregnant.
An ultrasound performed in September showed that the woman’s fallopian tubes were free from obstruction, but also revealed suspected polyps along the uterine wall.
Doctors scheduled an operative hysteroscopy for December, during which the suspect tissue was scraped away.
A subsequent examination of the discarded material revealed that it contained a fetal tissue.
While the woman’s chart included notation that two weeks had passed since her last menstrual period, on the day of the hysteroscopy neither the admitting nurse nor the doctor who performed the procedure had asked the woman about had her last period.
The doctor initially reported he didn’t know how information about the woman’s menstrual cycle ended up in her medical chart.
After the woman had been informed of the fetus’s removal, however, she explained that she had called the hospital’s gynecological clinic the day before the operation and said that her period was two weeks late.
Sweden’s National Board of Health and Welfare (Socialstyrelsen) has now issued a sharp reprimand against the doctor for failing to spot the woman’s pregnancy, adding that a pregnancy test should have been performed prior to the hysteroscopy.
The agency has also asked the hospital to review its procedures to ensure that future patients are asked about the last menstrual period before undergoing similar procedures.
The case was reviewed by the health board’s expert on obstetric and gynecological matters, who concluded that the mishap will not likely adversely affect the woman’s chances of getting pregnant in the future.